Swine Flu's Ebbs and Flows

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The Centers for Disease Control and Prevention and state health departments have begun delivering H1N1 vaccines to scores of colleges and universities across the country, and those inoculations are arriving in very different climates for the illness from campus to campus.

Some large outbreaks -- like the one at Washington State University that sickened more than 3,000 students in August and early September -- have mostly subsided, while new clusters of the virus are emerging at institutions that survived the first few weeks of the academic year unscathed but are now identifying flu-like symptoms among students, faculty and staff.

Jim Turner, president of the American College Health Association and executive director of the University of Virginia's student health center, said his group is “seeing a dropoff in disease now at many campuses and in many parts of the country.”

Data collected October 3 to 9 for the ACHA’s latest weekly report, released Wednesday, suggest that outbreaks of flu-like symptoms have peaked in most states in the Southeast, Northeast and Mid-Atlantic regions, while the Midwest, Southwest and Rocky Mountains are experiencing upticks in cases. During that week, a total of 5,959 cases were reported at institutions serving more than 3.1 million students, bringing the attack rate to 19.2 cases per 10,000, 2 percent higher than a week earlier.

Rensselaer Polytechnic Institute, in Troy, N.Y., for instance, has seen H1N1 emerge in the last 10 days or so, since a busy weekend that included major football and hockey games, as well as a career fair, said Leslie Lawrence, medical director of RPI’s Student Health Center. Sixty-four students have reported flu-like symptoms and 47 of the cases are still active. “We’re no different from any other campus,” he said. “We’ve seen these illnesses emerge after social events and other large events, just as we’ve heard would be the case.”

RPI is different from some places, though, for conceding that H1N1 has spread in places less savory than lecture halls, libraries and community service projects. In an e-mail message to students on October 9, Lawrence warned that “some of our current cases were apparently contracted during a weekend drinking game.” Seven students there got sick from the same game of beer pong.

He continued: “Do not share drinks. Alcohol does not kill the virus or prevent its spread from person to person. While it might seem fun over the weekend, it will not be enjoyable when you and your friends are sick and missing class or midterm examinations.”

Public officials have promised RPI administrators that the first batch of vaccines will arrive there in the next week or so.

Even with some campuses reporting growth in new cases, the ACHA’s statistics do show signs that conditions won’t get much worse before they get better. “It seems like we’re approaching the end of this wave,” Turner said. He anticipates that the virus will peter out in the next few weeks and result in “several weeks of flu-free time when we can rally the troops to get as many students vaccinated as possible before another wave of H1N1 this winter.”

The University of Alabama’s student health center saw about 50 cases of H1N1 during the first week of classes in August. Hundreds of students have reported flu-like symptoms since then but, in recent weeks, said Cathy Andreen, director of media relations, “there’s been a downward trend in the number of students coming in with flu-like symptoms.” Just a few students reported symptoms to the health center last week, she said.

But, she said, university health officials are nonetheless encouraging students and faculty and staff members to get vaccinated. The Tuscaloosa campus received its first shipment of the nasal spray inoculation Tuesday and began delivering it Wednesday at an employee health fair and an event in a residence hall. The injectable vaccine is set to arrive in early November.

Pam Spear, director of Colby-Sawyer College’s health center, said she “made a conscious decision not to deliver the mist” and instead to wait for H1N1 shots to arrive at the New London, N.H., campus in early November. “No students requested they wanted the spray and we’d rather go with the safer approach of the shot.”

James Tinney, director of media relations at Washington State, said his institution, which saw the early fall’s largest reported college outbreak, has yet to receive the H1N1 vaccine and isn’t sure when it will arrive.

Even without the inoculations, though, the number of cases there has dropped substantially. A few weeks ago, hundreds of students were contacting the campus health center each day about flu-like symptoms. Now, Tinney said, “it’s slackened off considerably -- they’re only seeing 10 or 15 people a day.”

The steep decline in cases, he added, has made university officials “optimistic … that the main outbreak of H1N1 is behind us…. A pretty significant percentage of our population has been exposed to it and we hope that even more will be protected from it by the vaccination. The expectation is that the worst of this is behind us.”

The University of Delaware saw its first spate of H1N1 cases last spring and, said Marcia Nickle, emergency preparedness coordinator, “we think it’s possible some students built up a level of immunity to it” and that helped protect the campus from a bigger outbreak this fall.

Since classes started in August, 43 cases of influenza-like illnesses have been reported among the institution’s student body of nearly 20,000. “We like to think our students have become much more aware of their health this year and are being much more vigilant about taking care of themselves,” she said.

Arlie Corday, director of communications and media relations at Wellesley College, said there have been a few dozen cases of what’s believed to be H1N1 since the start of the year, but that the college is “at a very quiet point with flu-like illness,” with no known cases right now.

Even if things do get worse, she said, “it doesn’t look to be a particularly burdensome problem for most people.”